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Evolución de la aplicación del concepto de integración curricular de simulación clínica: Una revisión con foco en el pregrado de carreras de salud
(SciELO Agencia Nacional de Investigacion y Desarrollo (ANID), 2025-01)
Francisca Torres Suazo
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Marco Bettancourt González
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Catalina Atuez Araya
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Matías Aravena González
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Yenny Plaza Órdenes
1
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Connexin46 in the nucleus of cancer cells: a possible role as transcription modulator
(Springer Science and Business Media LLC, 2025-03-27)
Ainoa Fernández-Olivares
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Viviana P Orellana
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Jesús Llanquinao
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NUÑEZ VASQUEZ, GONZALO ESTEBAN
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Pablo Pérez-Moreno
Scopus© Citations 1 10
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MET Exon 14 Skipping and Novel Actionable Variants: Diagnostic and Therapeutic Implications in Latin American Non-Small-Cell Lung Cancer Patients
(MDPI AG, 2024-12-22)
RIVAS VERA, SOLANGE VERÓNICA
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Romina V. Sepúlveda
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TAPIA DUFEY, JUAN IGNACIO
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Catalina Estay
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Vicente Soto
<jats:p>Targeted therapy indications for actionable variants in non-small-cell lung cancer (NSCLC) have primarily been studied in Caucasian populations, with limited data on Latin American patients. This study utilized a 52-genes next-generation sequencing (NGS) panel to analyze 1560 tumor biopsies from NSCLC patients in Chile, Brazil, and Peru. The RNA sequencing reads and DNA coverage were correlated to improve the detection of the actionable MET exon 14 skipping variant (METex14). The pathogenicity of MET variants of uncertain significance (VUSs) was assessed using bioinformatic methods, based on their predicted driver potential. The effects of the predicted drivers VUS T992I and H1094Y on c-MET signaling activation, proliferation, and migration were evaluated in HEK293T, BEAS-2B, and H1993 cell lines. Subsequently, c-Met inhibitors were tested in 2D and 3D cell cultures, and drug affinity was determined using 3D structure simulations. The prevalence of MET variants in the South American cohort was 8%, and RNA-based diagnosis detected 27% more cases of METex14 than DNA-based methods. Notably, 20% of METex14 cases with RNA reads below the detection threshold were confirmed using DNA analysis. The novel actionable T992I and H1094Y variants induced proliferation and migration through c-Met/Akt signaling. Both variants showed sensitivity to crizotinib and savolitinib, but the H1094Y variant exhibited reduced sensitivity to capmatinib. These findings highlight the importance of RNA-based METex14 diagnosis and reveal the drug sensitivity profiles of novel actionable MET variants from an understudied patient population.</jats:p>
Scopus© Citations 4 8
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A consistent moment equations for binary probit models with endogenous variables using instrumental variables
(2024)
Louis de Grange
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Felipe González
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Matthieu Marechal
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TRONCOSO OLCHEVSKAIA, RODRIGO VLADISLAV
7
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Simulation scenario design model for training clinical reasoning in undergraduate medical students
(2023)
Soledad Armijo Rivera
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Cristian Labarca Solar
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Cristian Pérez Villalobos
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Claudia Behrens Pérez
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Catalina Tamburrino Díaz
<jats:p>Introduction: Clinical reasoning is a complex task that physicians use when treating patients, and it can be carried out through intuitive and analytical processes. Clinical simulation is a tool to train reasoning, however, its evaluation remains challenging. In the present study, we evaluated the scenario design template for clinical reasoning associated with using an observation scale applied to medical students in two sequential simulation scenarios. Materials and methods: Two simulation scenarios with 4 levels of complexity were designed to manage sepsis in adult patients, where 12 groups of 8 students participated. These simulations were recorded and later analyzed by qualified observers through a guideline built on the conceptual proposals of Croskerry, Braun, and Pennaforte. Results: The scenarios were carried out in an average of 12 minutes. Most students established the diagnosis and initial management through the partial collection of information, showing control of intuitive reasoning in 98 % of the cases, whereas only 10,4 % achieved the analytical processes. Conclusion: The design of simulation scenarios composed of different levels of complexity could promote the development of clinical reasoning. Using an observation guideline allowed the analysis of the clinical reasoning process in realistic environments and without interruptions and could be used to guide debriefings.</jats:p>
8
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Comparison of achievement in anamnesis skills in on-site and online formative Objective Structured Clinical Exam
(2023)
Mariana Jadue
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Pilar Munitiz
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Luz-María Torres
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Marcelo Blacutt
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Soledad Armijo-Rivera
<jats:p>Introduction: anamnesis is an initial step of the clinical reasoning process, which is taught throughout interviews to real or simulated patients. Its evaluation through OSCEs is widely disseminated, and in the context of a pandemic, the OSCE was adapted to be administered online. Objective: to compare the levels of achievement in anamnesis skills of two cohorts of medical students in formative OSCEs of semiology in on-site and online modality. Methods: using a blueprint established in 2017 and implemented for three years, competencies were identified that could be trained and evaluated online in third-year medical students. Telesimulations were performed with role play for anamnesis ability. Guided by a tutor, each student participated in 10 telesimulated anamnesis with peer roleplay and one anamnesis with a simulated pacientent. All of it in groups of 6 students. A formative TeleOSCE was implemented, evaluating the same skills of the year 2019 in a face-to-face training instance. In 2019 and 2020, 92 and 91 students participated respectively. The students' performance was compared in three identical scenarios. Results: at the cough, acute diarrhea, and knee pain screening scenarios, students in the 2020 cohort performed better than those in the 2019 cohort (p<0,001). Conclusions: for the development of anamnesis skill in third-year medical students, telesimulation-based teaching allows students to demonstrate adequate performance on a practical assessment administered online via TeleOSCE.</jats:p>
Scopus© Citations 3 7
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Percepción de la simulación en obstetricia y ginecología en el pregrado y posgrado de una universidad privada chilena
(2023)
Elisa Díaz-Reiher
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María del M. Mora-Mourguiart
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Valentina Fuentes Lomb
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Victoria Sepúlveda-Camhi
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Rodrigo Latorre-Riquelme
7
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Comparing allocation and relocation policies at a logistics service container terminal: a discrete-event simulation approach
(2023)
JUAN PABLO CAVADA HERRERA
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Cristián E. Cortés
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Pablo A. Rey
5Scopus© Citations 1
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Comparison of Three Daily Rainfall-Runoff Hydrological Models Using Four Evapotranspiration Models in Four Small Forested Watersheds with Different Land Cover in South-Central Chile
(2021)
Neftali Flores
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Rolando Rodríguez
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Santiago Yépez
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Victor Osores
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Pedro Rau
We used the lumped rainfall–runoff hydrologic models Génie Rural à 4, 5, 6 paramètres Journalier (GR4J, GR5J and GR6J) to evaluate the most robust model for simulating discharge on four forested small catchments (<40 ha) in south-central Chile. Different evapotranspiration methods were evaluated: Oudin, Hargreaves–Samani and Priestley–Taylor. Oudin’s model allows the achievement of the highest efficiencies in the flow simulation. The more sensitive parameters for each model were identified through a Generalized Probability Uncertainty Estimation (GLUE) model. Our results demonstrate that the three hydrological models were capable of efficiently simulating flow in the four study catchments. However, the GR6J model obtained the most satisfactory results in terms of simulated to measured streamflow closeness. In general, the three models tended to underestimate peak flow, as well as underestimate and overestimate flow events in most of the in situ observations, according to the probability of non-exceedance. We also evaluated the models’ performance in a simulation of summer discharge due to the importance of downstream water supply in the months of greatest scarcity. Again, we found that GR6J obtained the most efficient simulations.
4 1Scopus© Citations 33
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Modelling cost-effectiveness of syphilis detection strategies in prisoners: exploratory exercise in a Chilean male prison
(2021)
CASTILLO LABORDE, CARLA CECILIA
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Pedro Gajardo
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Manuel Nájera-De Ferrari
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MATUTE WILLEMSEM, MARIA ISABEL
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Macarena Hirmas-Adauy
<jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Syphilis, together with other sexually transmitted infections, remains a global public health problem that is far from controlled. People deprived of liberty are a vulnerable population. Control activities in prisons rely mostly on passive case detection, despite the existence of affordable alternatives that would allow switching to active case-finding strategies. Our objective was to develop a mathematical modelling framework for cost-effectiveness evaluation, from a health system perspective, of different approaches using rapid tests for the detection of syphilis in inmates' populations and to explore the results based on a Chilean male prison population.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>A compartmental model was developed to characterize the transmission dynamics of syphilis inside a prison with the ongoing strategy (passive case detection, with VRDL + FTA-ABS), considering the entrance and exit of inmates over a 40 year period. The model allows simulation of the implementation of a reverse algorithm for the current situation (rapid test + VDRL), different screening strategies (entry point, massive periodically; both with rapid test + VDRL) and treatment of detected cases. The parameters for the exploratory exercise were obtained from systematic searches of indexed and grey literature and field work (EQ-5D questionnaire application and key actors interviews). Probabilistic sensitivity analysis was conducted to account for uncertainty in relevant parameters.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>The proposed framework allows the evaluation of different detection strategies. In this study, all the strategies were cost-effective in the baseline scenario when considering an ICER threshold of 1 Chilean GDP per capita (US$15,000). The strategies most likely to be cost-effective (over 80% probability) were: current situation with reverse algorithm, entry point screening and mass screening every two years; the latter was the most effective, achieving the lowest prevalence (0.7% and 1.7% over the period versus the 3% prevalence in the current situation).</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Mathematical modelling that considers the performance of different tests and detection strategies could be a useful tool for decision making. The exploratory results show the efficiency of adopting both the use of the rapid tests and performing active case detection to significantly reduce the burden of syphilis in Chilean prisons in the near future.</jats:p> </jats:sec>
Scopus© Citations 5 1

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